Technology-Assisted Mental Health Interventions Developed for Frontline Healthcare Workers: A Systematic Review

Background and Purpose: Over the last decade, frontline healthcare workers (FHCW), who comprise 14% of the U.S. workforce, experienced significant increases in depressive symptoms, anxiety, and burnout. Despite the increase in mental health symptoms, FHCWs face significant treatment access disparities. Technology-assisted mental health interventions have demonstrated efficacy for treating depression, anxiety, and burnout, and provide an opportunity to increase access to care. However, these interventions are often designed to be a one-size-fits-all model and do not reflect the unique lived experiences and realities of, and subsequently do not appeal to, FHCWs. The goal of this systematic review is to identify and synthesize existing literature reporting the development and/or effectiveness testing of technology-assisted mental health treatments specifically for FHCW.

Methods: Literature reporting the development and/or effectiveness testing of technology-assisted mental health interventions for FHCWs published between 2014-2025 were reviewed in March and April of 2025. For inclusion, studies had to 1) focus on or sample FHCWs aged 18+, 2) report on or assess the development and/or effectiveness of technology-assisted mental health treatments/interventions, 3) be conducted in the US, and 4) be published in English language peer reviewed journals. Articles meeting criteria were identified via searches in electronic databases including PubMed, Web of Science, PsychInfo, CINAHL, and Google Scholar. Search terms used alone or in combination were: FHCW, healthcare worker, depression, anxiety, burnout, mobile mental health intervention, technology-assisted mental health treatment, technology-assisted mental health intervention, online mental health intervention, computer-assisted mental health intervention and digital mental health intervention.

Results: Eighteen articles published between 2018 and 2025 met inclusion criteria. The majority of articles (n=15) were published after the start of the COVID-19 pandemic, with about half of those articles reporting on interventions specifically developed for FHCWs in response to COVID (n=7). Additionally, over half of the articles (n=10) utilized mindfulness and mind/body therapeutic intervention strategies to address FHCWs’ mental health or burnout symptoms. Only one article reported using a cognitive behavioral approach. The additional seven articles were developed using third wave modalities. Moreover, the majority of articles (n=15) were studies testing the effectiveness of interventions, while very few discussed the development of interventions (n=2). Additionally, one RCT met inclusion criteria. Lastly, although all articles reported a decrease in depressive symptoms, anxiety, and/or burnout amongst FHCW participants, there was little to no FHCW input in intervention development.

Conclusions and Implications: This review highlights the need for accessible and relevant mental health interventions specifically tailored for FHCWs. Many interventions focused on reducing burnout and stress while increasing resilience using mindfulness-based strategies, however, the review identified limited interventions focused on evidence-supported mental health treatments for depression and anxiety among FHCWs. Additionally, few studies reported on participant engagement, which limits our understanding of intervention accessibility and acceptability among FHCWs. Future research using community-engaged approaches to involve FHCWs in the mental health intervention development process is warranted and critical to address mental health engagement treatment gaps.